Individual
MIRANDA G IDEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 880-7812
Mailing address
200 S MANCHESTER AVE STE 300, ORANGE, CA 92868-3219
(714) 456-2986
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
845670
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125598
NBCRNA
—
Enumeration date
04/01/2019
Last updated
01/24/2023
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